As noted in our 2012 Revelations post, when continuous glucose monitoring is accurate and user-friendly, I find it to be an incredible tool that actually becomes difficult to live without!

I've been living with the G4 since mid-November, am actually enjoying the experience, and feeling pretty darn lost when I'm disconnected. It is not perfect -- but what a difference from the older model!

Specifically, my complaints with older-generation CGM were:

- itchy, uncomfortable adhesive that often wouldn't stay put

- far too many unnecessary beeps (overnight!!), with sounds not adjustable either in tone or volume

- too limited transmission range, which caused mine to poop out multiple times a day

- LOTS of inaccurate readings, or at least numbers that didn't hardly match up with my fingerstick meter

- as one reader noted, CGM sensors tend to be "fussy little devices" and that old egg-shaped, black-and-white-screen receiver did not appeal to me at all.

With this next generation, Dexcom has addressed nearly all of these issues, and certainly made the device 100% more liveable, if you ask me. And liveable is what it's all about, right? Because no patients will get any value out of tech devices that they cannot stand to live with on a daily basis.

Sticky Issues

I'll admit I had a rough start with the G4. The first three or four sensors I tried simply refused to stick to me for more than 2 or 3 days. As you may know, I've always had skin issues with medical adhesives, and was beginning to think I'd have to rule out the G4 on teflon troubles alone.

But the Dexcom rep came to the rescue with a whole host of suggestions:

- use a loufa scrub to exfoliate the dead skin on your site area before insertion

- steer clear of steamy bathrooms when making site changes

- put pressure on all sides of the dressing when you first adhere it

- possibly use a ziplock baggie to cover the sensor while showering (OK, this one's a pain in the #@$!)

- when exercising, use deodorant around the site to ward off perspiration

I went out and bought the first loufa of my life, and discovered that it's nice to exfoliate (!), especially in hard-to-reach itchy spots. But back to the CGM: it does seem to help, because between loufa-ing and the Skin Tac wipes, my sensors are sticking incredibly well now! And they hardly itch, either.

Helpful disclosures on above tips: Watch out for Skin Tac! It works great, but it's like superglue on your fingers, so have a medical adhesive remover wipe handy as an antidote; using deodorant around the site before exercising was a disgusting mess -- not recommended!; spending an extra minute or two pressing down the adhesive when first inserted seems worth the time, if a little funny-looking to anyone sharing your bathroom; and pasting a ziplock to your belly before showering?! I think not! That's worse than the first-gen CGM, which required special waterproof covers, and those at least were mostly custom fit with built-in adhesive. I have not yet tried the Blenderm Tape, and would only consider this as a last resort ('cause medical tape all over my tummy is way-low on my "live-ability" list, of course!)

Speaking of Live-ability

Why do I find this model so much more appealing? First off, accuracy. In almost two months of wear, I haven't found the readings more than 20 points off what I'm getting on my OmniPod's built-in meter, so I have a sense of trust in CGM for the first time ever.

Because of the increased accuracy, it's no longer like living with a fussy newborn, bound to set off screaming at any time of day or night for no compelling reason. Nope, I've only had to hide it in my underwear drawer once in nearly eight weeks -- and that was a night where I really was hovering too close to my low alarm range.

The increased transmission range (quadrupled up to 20 feet!) is also a HUGE factor for me. I can now go into the next room, or even upstairs sometimes, come back and discover no interruption in my continuous glucose readings -- fantastic! AND, when it does lose the signal, it seems to take just a few minutes to reconnect once I'm back in range, without going all haywire and showing me ??? messages and crazy-off readings like the older model did.

Everything else is pretty much about the form factor. Design Matters! I'd like to shout that from the rooftops!

This thing looks and feels far more like modern consumer technology, and the color screen makes an incredible difference for me. I can't even explain why, but the screen "pops" and speaks to me a thousand times more than the old drab shades-of-grey screen did. I guess for anyone who grew up with color TV (hello, I'm not that old!), color creates a visceral reaction necessary for us to "wake up and smell the coffee," so to speak.

Of course, you now get color options for the Receiver unit itself. I chose Ocean Blue. But since most of us carry our Dex in that still-dorky black case most of the time, we don't get much benefit from the fun cover colors, IMHO.

You can set the alarm tones to Vibrate, Soft, or Normal, so basically two volume settings -- which is one more than we had before! I prefer "Soft," which is plenty loud, especially when you are sleeping, believe me. Aside from the "Normal" beep, you can also choose a tone called "Attentive," a funky digital jingle that I don't find appealing at all -- but again, it's more user choice than we've ever had with a CGM in the past.

Things Unchanged

As noted in our earlier review by Wil Dubois, the inserter contraption has not changed one bit ("same dental tool from hell," he writes -- he, he!) I would have liked something with less of a voilent plunge, but I still find it better than Medtronic's inserter beast, and at least the insertion is over in seconds and only required once every seven days.

What surprises me is the claim that the sensor is now 60% smaller. Sixty percent is a lot! But as a user, I find the sensor doesn't feel one bit smaller. In fact, the rounded top makes it feel even a little more protruding than the old squared-off design. But the softer corners definitely add to a sense of increased comfort.

I just watched Dexcom's promo video again for perspective, and had to smirk at those models looking so delighted to carry their Receivers around, checking them every 20 seconds while exercising, eating, sleeping, walking, etc. What remains unchanged for me as a drawback of CGM wear overall is the constant nagging obligation to keep track of yet another device that needs calibrating and charging, and beeps at me after every meal plus plenty of other times too. Shoot! Did I leave it on the bedside table? Or in that jacket pocket? Did I forget the charger on this trip...? Oh shut up now, I know I'm high after breakfast! Geez...

Trade-Off Hurdles

Yes, I am grateful (moreso now than ever) for the insight CGM gives me into my ever-changing BG levels. But the choice we have to make with every diabetes / medical tool available is whether the benefit is worth the trade-off in hassle and aggravation. Does it actually make your life with diabetes better, or just more complicated?

As far as the G4 sensor and Receiver go, I'd say Dexcom finally cleared the trade-off hurdle. Hooray! I'm planning to stick with this one for a good long while.

My next challenge is to start playing with the new Dexcom Studio Software, which I've just now downloaded on my PC, but would prefer to use on my MacBook, truth be told. This new logging software is supposed to be Mac compatible, but other early users report that the USB driver for the G4 doesn't seem to be working on iMac, so you may need to download the data using a PC and then move it yourself to iMac, every time you want to download data. Ugh! See statement above about making life better versus more complicated.

For me personally, no logging tool has cleared the trade-off hurdle for continuous use yet, but I remain hopeful, as always.

[Please note: Dexcom Disclosure. I was not paid to write about this product; all opinions are personal and completely uncensored.]

Disclaimer: Content created by the Diabetes Mine team. For more details click here.

This content is created for Diabetes Mine, a consumer health blog focused on the diabetes community.
The content is not medically reviewed and doesn't adhere to Healthline's editorial guidelines.
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Archived Comments

Hank|2013-01-09

I hope your not using Windows 8 on your PC. The Studio software will not run on it. As good as Dexcom is in providing a decent CGMS, they are certainly lacking in their software system compatibility.

droberts0503|2013-01-09

I've had mine for a couple of months and just put it back on after a 10 day break. I'm not really satisfied with it but I'll wear it from time to time. 2 out of my first 3 sensors failed and getting hold of support was terrible. I couldn't get through on the phone and no one replied to emails. After a few weeks I got a call by somebody who seemed completely uninterested and just went through the motions. Not even close to acceptable in my book.I do agree with the good things listed. The range is nice, I can actually set alarms and not have them erroneously triggered 5 times a night, I don't have massive differences in readings and its smaller. I also gave issues with it sticking. The one I'm wearing lasted about 6 hours before one side was unstuck. I use IV3000 but its not perfect since you have to cut a hole in it. The receiver scratches easily and things like not being able to scroll your results when zoomed in are user annoying. The other issue for me personally is I don't get much out of the data.Overall its better than the seven+ but I doubt I'll be using it all the time, just now and again.

Terry|2013-01-09

I too use a MacBook as my primary computer and wish that Dex made their download analysis software compatible with Macs. I also started on the G4 last November and would have trouble living without it.When I started with the Dex 7+ in '09 I bought a relatively inexpensive netbook PC computer. I dedicate it to my diabetes tracking. I know, that's more complicated than a single computer for everything, but it works well for me. The Studio software runs well on my Vista-based netbook. I also run an Excel spreadsheet on this machine that tracks my basal rate changes.Using the download capability provides me with a major benefit of the Dex. It helps me to make changes to my basal rates and overall adds motivation to produce better numbers. (I'm really focused on keeping my standard deviation at < 30, an ambitious yet attainable goal for me.) Using a CGM without downloading shortchanges the full potential of this device.

Mary|2013-01-09

I love everything you wrote. I am still using up my old 7+ stuff before I get to move on to the G4.I think the only thing that I would say is about the sensor being 60% smaller. The sensor is the wire - and it IS (apparently) 60% smaller. However, the transmitter is larger. But I am also a fan of the rounded top and corners of the transmitter.

AmyT|2013-01-09

@Mary - ah, right you are! There's a design disconnect, however. What I would care about is the whole sensor unit actually being smaller on my body.

Hope|2013-01-09

I just got to do a trial with the Dexcom 7, and loved it. I actually was able to keep the sensor in for about 18 days, but near the end I had to trim the edges of the adhesive patch, which were starting to curl, and cover with a Tegaderm. Unfortunately my insurance has ruled it to not be a medical necessity, though it was a *great* adjunct to my diabetes management. We're going to try to appeal, but - we'll see.

Sara Clark|2013-01-09

I am on my second week with the new G4 and I love it! I used the Dexcom 7+ and older versions for years and was increasingly not satisfied. Most of my concerns have been taken care of in this version, plus some. The fact that the casing for the transmitter protrudes more and there is no MAC compatible software are my only complaints. I still own a PC so I can use it but the PC isn't my everyday computer. I love the ability to adjust the volume and vary the tones. I also love that the screen is in color. This wasn't previously a concern but it makes it much more easy to visually assess how I did on a given day. A lot of yellow or red lets me know that I need to make some adjustments. A lot of white lets me know I am having a good day. I also appreciate that the buttons are quieter so when I am pushing them in the middle of the night, I don't wake up my husband. I also love that I don't loose transmission as I walk around my house and don't have to carry it around the house with me. If it is in my bedroom, I can be almost anywhere in my house and still get readings.

Monica|2013-01-09

I am pretty sure this will not work on a Mac. The software runs on the .NET framework, so it will definitely not work on a Mac, even if there were (or happened to be) drivers programmed for a Mac.Programs written in Java are platform independent (work regardless of operating system), as long as there is a driver written for the specific operating system.

Megan|2013-01-09

I am still using up my Seven Plus sensors but have the G4 ready and waiting to start up. I just wanted to mention to you that I use Smith and Nephew Opsite Flexifix around (not over) my sensors and it keeps them on for 14+ days with no issues. It is super flexible and dries out fast after showers. I cannot feel the tape at all since it moves with your body. I currently have one on my arm for the first time, cannot feel it one bit and it is incredibly accurate after 10 days. I use the 2 inch wide roll and have a pattern that I cut out for each half and then place them over top the built in tape and have a small overlap on the edges. This tape works great for sets too, I just cut out a hole to go over the disconnect area. WIthout this tape my sensors would fall or or get ripped off in a matter of days.

mollyjade|2013-01-09

How in the world are you supposed to avoid applying the Skin Tac in the center of the new site? I can't picture any way to do that reliably.

AmyT|2013-01-09

@mollyjade - this may sound weird, but I actually used a ballpoint pen to draw a small oval on my belly marking the part to avoid wiping with the Skin Tac. Oh, the indignities we have to put up with for D-management, no?!

Elle|2013-01-09

This is my first time ever posting anything on the internet but i just had to second Amy's findings on the new dexcom and share our experience with it! My eleven year old son has been using the g4 for two months. It has been so incredibly accurate and helpful and we are so happy with it. I feel so much more relaxed knowing that he is wearing it and have absolutely come to rely on its predictive alarms. We still do finger stick tests to confirm the dex readings (especially before correcting) but the device is really accurate most of the time. Avoiding the real lows has alliowed him to prevent the highs that follow those lows and his numbers are so much better overall. I can't wait to see how it has helped his A1C. I felt sad to read that some insurance isn't covering the dexcom. It is absolutely a medical necessity. My wishes for the next gen device would be greater range, smaller transmitter and compatibility with pumps. Thankfully, I believe that is all in the pipeline and achievable. The most important part of the CGM puzzle seems to have been solved with this device: ACCURACY. The rest are the easy things to fix ... Lastly, their software is very very good. Select the seven day review option and it will probably find a few suggestions for you on highs and lows.

TC|2013-01-09

My 10 year-old has been using this for about a month now and I love it. We haven't had any sensor problems and the readings are usually within 10 points of the fingerstick (which is within its margin of error). I love the studio software which has lead to vastly improved basal settings. We have been able to reduce from 11 fingersticks a day to 7 or 8. We used the MM CGM, but hated it. This is love and would work an extra job if I needed to just to pay for it.

David Downs|2013-01-10

Amy, I got the same color and carry it without the case. I'm enjoying the same accuracy and range benefits. Bravo Dexcom! I am also super-excited about the Tandem announcement where they will integrate G4 data into their next pump. Also, they're movin forward with research into a dual chamber pump (insulin + glucagon). The future looks brighter every day!

Doug|2013-01-10

Re using pen tyo make circles ive been doing the same since the days of the navigator ...the fun part is putting he sensor in the middle of the circle on he back of my arm with my left ( non dominate ) hand,

Mary|2013-01-14

I hear ya! My elbow catches on it already (I wear the Dex mostly on my hips). I would have loved a smaller receiver too. Maybe on the next one!

SARA|2013-01-25

Don't give up on your insurance so quickly. I had to persist with my insurance and with help from my doctor, his insurance team and write a couple of letters to challenge their decision, I am now wearing my Dexcom G4. Do a google on the internet to see how other people have overturned insurance decisions, and persist. Some insurances WON'T cover the device, but don't give up without a fight.

droberts0503|2013-01-25

Just an update about the last few weeks. I've had one sensor act all crazy. As in reading in the 40's when my BG was mid 100's, jumping from 70 to 200 and back down to 70 in 10-15 minutes and slowly rising from to 150 and then down to mid 80's over the course of 45 minutes despite not eating anything or taking any insulin. These things happened repeatedly over the course of the first 12 hours after inserting it. I shut it down, went to bed and restarted it and it was fine for a week. The following week the sensor fell off despite being taped down. I still have serious doubts about the quality of the system as a whole and these incidents don't do anything to put my mind at ease. When it's works it works fine. It's very accurate and not annoying. However, for me I have had too many issues with it considering the cost and the approval process it had to go through. I'm sure there will be a time when I take it off, store it away and stop re-ordering sensors because of all the issues and just wait for the next generation or competitor to come along.

Alexandre Cataldo Lopes|2013-01-31

Elle, I've read your posting and it filled me with hope, about diabetes management for my 7-years-old daughter (DM 1 since 2008, when she was less than 3-years-old). Me and my wife are considering some kind of CGM, but we were waiting for her to arrive at 7.I'm pretty much interested in trying this Dexcom G4.We live in Brazil. Do you know if Dexcom G4 (and the sensors) can be bought online? If not, where it can be found in the U.S. (i mean, in which kind of stores)? Asked it because i'm going to Florida on next June.Obviously, I share your concern and interest in maintaining glucose our children in regular levels most of the time... So i'm eager for informations about G4 and specially how to acquire it.Thanks in advance.My e-mail is alexandre_cataldo@hotmail.com

Kelley Barber|2013-02-07

I am considering a CGM, I have never used one. Does the Dexcom G4 work with the animas ping? What does it mean when they say "integrated" with the pump?Thank you!Kelley

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